Chapter 6
[Remaining time : 00:06:51]
If things went on like this, in seven minutes I'd miss out on 1,000 LP and a hidden trait right before my eyes.
No good.
I had to grab at even a straw.
In the end, I decided to reach for my last resort.
I just couldn't resist the hive mind.
Once again, I conjured [Dead Medical Scholar Gallery] in midair.
Title : Urgent) Male patient in his 50s, sensory disturbance
Author : HellJoseonSlave1
R/O acute gastroenteritis. N/V/D, abd pain
(*Abdominal pain)
Chief complaint. Vitals stable, labs unremarkable. But cold-hot reversal
(*Cold-hot sensation reversal)
Findings noted. Feels cold water as warm. What should I rule out first? No time.
Posted.
The moment I hit the button, comment notifications started flooding in like crazy.
ㅇㅇ (210.94) : No, seriously, are you actually alive!!!!
Descendant of Hippocrates : Sensory disturbance, so could this be a stroke? Describe the physical exam findings in more detail.
PediatricsGhost77 : Hey, you bastard, say something!!!! Don't you have any intention of communicating with us!!!!
As expected.
These ghost bastards weren't interested in my question at all; they were only obsessively fixated on me.
Just then, that IP showed up again.
ㅇㅇ (118.235) : Are you an idiot? Ask about Southeast Asia travel history or what fish he ate first. Re-interview him, go go.
Huh…?
Fish…?
Suddenly…?
I narrowed my eyes.
Southeast Asia travel? Fish? What on earth do those two have to do with gastroenteritis symptoms and temperature-sensation reversal?
No matter how much I mobilized every bit of medical knowledge in my head, I couldn't find the connection.
What Descendant of Hippocrates said, suspecting a stroke, honestly sounded more plausible.
The gallery—no, that anonymous handle 118.235—seemed suspicious.
But I don't have a choice now. Four minutes left. I've got nothing to lose.
I headed back to bed B-17.
The patient, even paler than before and groaning, painfully opened his eyes when he saw me.
“Doctor, what is it this time…?”
“Sir, I just need to ask a few more things. It's important.”
“Have you traveled to Southeast Asia recently?”
The patient shook his head.
“Southeast Asia? I've only ever been to Jeju in my whole life. What Southeast Asia?”
The first clue was off.
“Then did you perhaps eat sashimi or some unusual fish dish yesterday or today? Something you don't normally eat.”
At my question, the patient's eyes faintly lit up.
“Ah, fish!”
“Yesterday at lunch, our boss came back from the Philippines and brought braised fish... what was it called again? He said it was Lapu... something or other. About three or four hours after eating it, my stomach turned upside down and this mess started.”
Philippine fish, lapu-lapu.
I shouted to the patient, “Got it, please wait a moment!” and ran back to the station like a madman.
Then I immediately posted a second message in the gallery.
Title : Anon, get in here ㅇㅇ
Author : HellJoseonSlave1
I got an answer, but why did you tell me to ask in the first place?
Patient says he recently ate Philippine fish (lapu-lapu). No travel history; says an acquaintance brought it. What is this?
And then
Not even a second after my post went up.
The gallery exploded.
ㅇㅇ (210.94) : Hahahahahahahahahahahahahahahahahahahahahahahahahahahahahahahahahahahahahahaha
PediatricsGhost77 : You dumb bastard, what are you doing hahaha. I set the whole table for you, and you're asking me to spoon-feed it to you hahaha.
OperatingRoomGhost3 : Hahahahahahahahahahahahahahaha, I'm losing it for real hahaha. Is this bastard actually a doctor? hahaha
Descendant of Hippocrates : So you're definitely alive. And it's also clear you're far more foolish than I imagined.
ㅇㅇ (1.234) : He's definitely alive, and it's definitely true this bastard is an idiot lol
What, have these crazy ghost bastards all gone nuts together?
Then, amid all that mockery, the answer I wanted finally appeared.
ㅇㅇ (118.235) : Ciguatera
(*Ciguatera, a type of tropical food poisoning)
I just told you, you idiot.
It starts with gastrointestinal symptoms, then headache, muscle pain, and the temperature-sensation abnormality you saw is a hugely characteristic symptom. You learn it in toxicology, you bastard.
Ciguatera. Ciguatoxin.
Right, there was such a thing.
That rare toxin I'd just underlined in a book and moved on from, thinking I'd never see it in Korea in my entire life.
In the end, I found the answer again with the help of these crazy ghost bastards.
Of course, I was treated like a quack.
[Remaining time: 00:01:21]
There's no time now.
“Dr. Choi Sumin!”
I shouted to the senior sitting at the station.
“B-17 patient has ciguatera fish poisoning!”
All the noise at the nursing station stopped in an instant.
The sounds of chart pages turning, phone rings, even idle chatter all fell silent.
My senior's eyes clearly said, 'What bullshit is he spouting now?'
“Hold on a second, Hyunjae. Ciguatera? That tropical fish toxin?”
The reaction was perfectly normal.
Ciguatera.
At most, a disease that only turns up in case reports from the far south, like Jeju.
A textbook disease you might encounter once in your life, if at all, as a clinician in Korea.
And a first-year resident diagnosed such a rare disease in a gastroenteritis patient?
If I were the senior, I wouldn't believe it either.
I continued, gasping for breath.
“The patient says he ate a dish made with a fish called lapu-lapu that an acquaintance brought back from the Philippines yesterday. A few hours later, the gastrointestinal symptoms started, and now he's even showing cold-hot sensation reversal.”
As soon as I finished, my senior's eyes flew open.
“…Ah, hey! That's right!”
With a brief exclamation, my senior turned without hesitation and put his hands on the keyboard.
Clack-clack-clack-clack-!
My senior began inputting orders into the EMR at a crazy speed, like a storm.
“Start another IV line and calculate mannitol at 1 gram per kilo with a 20% solution, then load it over 30 minutes! Right now!”
“EKG
(*Electrocardiogram, ECG
) Keep continuous monitoring and check blood pressure every hour! Bradycardia
(*Bradycardia, slow heart rate)
Watch closely for hypotension!”
“Give 300 milligrams of gabapentin right now, and if the pain isn't controlled, give more on schedule!”
“We need to check urine output, so Foley
(*Foley catheter, urinary catheter)
right away!”
Holy shit.
I stared blankly at the scene and let out an exclamation.
A third-year is a third-year for a reason.
The speed is on a whole different level.
I had only tossed out the diagnosis of ciguatera, but my senior was already pouring out orders like a storm without even time to think.
Is this what experience is?
If it were me, I'd definitely have had to look up books, ask my senior, and groan over it for ages to issue those orders one by one.
But my senior finished the whole process in just a few dozen seconds.
I genuinely came to respect my senior.
My savior—the one who saved my life, no, my LP.
[Remaining time: 00:00:12]
[Remaining time: 00:00:11]
Just before the quest timer ran out, Choi Sumin finally hit Enter with force and confirmed the last order.
Phew. I made it.
I let out a sigh of relief.
Even though I hadn't done anything beyond making the diagnosis, the quest was successful anyway.
1,000 LP and a hidden trait.
What kind of hidden trait could it be?
This is the moment to look forward to. Heh heh.
At that very moment.
Ding~!
With a quiet, cold notification sound, a new system window popped up in my field of vision.
[You left the treatment to another doctor!]
[Earned LP is reduced by 50%!]
[Final reward: 500 LP, Hidden Trait Unlocked (Locked)]
“….”
My brain stopped.
What?
Earned LP reduced by 50%?
1,000 points instantly became 500.
And even the Hidden Trait Unlocked had that damn (Locked) parenthetical attached to it.
No, I asked the gallery and told them about it!
I was the one who found it!
How irrational and absurd is it that the reward gets cut in half just because my senior placed the order!
I heard something snap inside me.
Fatigue, tension, and anger at the injustice mixed together and numbed my brain, and before I knew it I blurted out my inner voice without a filter.
“What the fucking hell!”
It was too loud to be called a mutter, and too small to be called a shout.
The rapid clacking of my senior's keyboard stopped.
All the air in the ER froze.
Choi Sumin slowly turned away from the EMR screen and looked at me.
An unreadable expression, a face covered in shock and confusion.
Choi Sumin asked me quietly.
“...Hyunjae, what did you just say?”
…Huh?
Did I just swear out loud?
Seriously? I said it out loud? A full-blown curse?
In front of my senior?
Am I crazy or what?
Yes.
Han Hyunjae, first-year emergency medicine resident.
I, a total rookie, had become a lunatic who hurled a string of curses at the orders my senior had given, right in front of the 3rd-year senior known as the angel of the ER.